Health Group Research Articles

Examining ED Utilization and Hospital Admissions among Older Undocumented Immigrants: Insights from a Primary Care County Program.

Limited access to preventive healthcare among undocumented immigrants may increase healthcare needs with age, leading to higher Emergency Department (ED) utilization and hospitalizations. While county programs like My Health LA (MHLA) in Los Angeles County (LAC), California, provide primary care to older undocumented adults, our understanding of the group's specific health issues prompting ED visits and potential legal status differences in ensuing hospital admissions is limited.We compared legal status differences in the likelihood of an ED-originating hospital admission among older immigrant patients in LAC. We examined the top 10 diagnostic categories for undocumented (MHLA and non-MHLA participants) and documented patients to understand the health conditions that bring older immigrants to the ED and those that result in hospital admission. This retrospective study analyzed 239,861 ED encounters from 2016 to 2020 across three LAC safety-net hospitals involving immigrant patients aged 50+. Multivariable mixed-effects models estimated the relationship between patient legal status and odds of ED-originating hospital admission. Undocumented patient encounters, both MHLA (OR=0.75, 95% CI: 0.71-0.78) and non-MHLA (OR=0.88, 95% CI: 0.85-0.91), were less likely to result in ED-originating hospital admissions than documented patient encounters. The top clinical reasons for treat-and-release (i.e., ED visits discharged home) visits and ED-originating hospital admissions among undocumented immigrants were similar to those of their documented counterparts. Older undocumented patients in MHLA were less likely to be admitted following an ED visit. Health programs should be designed for both documented and undocumented patients.

Narrative Review of the Morphofunctional Underpinnings and Comprehensive Rehabilitation Strategies for Smartphone-addicted University Students

The widespread availability of mobile phones has contributed to a high prevalence of digital addiction worldwide. Smartphone addiction or problematic smartphone use (SA/PSU) has become a widespread issue, especially among university students. Due to concerns about SA/PSU and cyber addiction in young people, research has focused on the structural and functional effects on the brain and the behavioral consequences of spending too much time on mobile phones. This review investigates the impact of excessive smartphone use on this demographic group's physical and mental health. An advanced search on PubMed based on primary keywords, clustered in syntactic associations looked for academic work focusing on: ((((smartphone addiction) and (problematic smartphone use)) and (students) and (Physical exercises)) and (Physical Activity). The relationship (((smartphone addiction) and (problematic smartphone use) and (systematic review) identified 22 papers, published between 2016 and 2024, 16 of which were during the Covid era and post-pandemic periods (2020-2024). Smartphone overuse-induced alterations in cerebral gray matter were observed in four trials. The beneficial influence of physical activity on smartphone addiction was emphasized in 11 publications (selected 9) identified by the advanced search with the syntactic relationship. The narrative review offers a comprehensive overview of effective strategies for addressing SA/PSU. This includes utilizing exercise and psychological interventions to combat digital addiction. Furthermore, studies have looked into the potential benefits of physical exercise and specific strategies addressing these issues. Engaging in physical activity may help offset the negative effects of SA/PSU, and targeted strategies are necessary for preventing and treating these problems in young people. Political and educational decision factors must implement targeted strategies and integrated social education policies to prevent smartphone overuse and pejorative consequences in adolescents and young people.

"You're Just Stuck in a Hole, Really": Mechanisms of Structural Racism Through Migrant Agricultural Worker Housing in Canada.

Worldwide, migrant agricultural workers face poor housing conditions and related health challenges. A growing body of research has documented the substandard housing often occupied by this largely racialized population. Yet limited health research has examined mechanisms of structural racism that determine this group's poor housing and health. Drawing on interviews with 151 migrant farmworkers in Ontario and British Columbia, Canada, we documented the housing experiences faced by migrant agricultural workers and examined the role of structural racism in determining housing and health inequities. Our analysis identified four overlapping mechanisms by which migrants' housing and health were determined by structural racism: (1) scarcity, (2) segregation, (3) sacrifice, and (4) stagnation. These mechanisms both reinforced and normalized housing hardships, making it difficult for migrants to escape unsafe or inadequate housing. Our findings point to the need for immediate action to improve housing conditions for this population and to interrogate the racist design that keeps migrant workers at the margins of society.

The impact of public art education on college students' mental health literacy.

This study aims to explore the impact of public art education on the mental health literacy of College Students. Conducted over a four-month period, the intervention involved freshmen from a Chinese college, comparing 1,334 students in the experimental group with 1,139 in the control group. Data were collected through a self-developed questionnaire and a standardized mental health literacy scale before and after the intervention. Results showed that the experimental group's overall mental health literacy score significantly increased from 64.051 pre-intervention to 79.260 post-intervention, while the control group showed no significant changes during the same period. The experimental group demonstrated significant improvements in their ability to identify psychological disorders, belief in receiving professional help, attitudes towards seeking appropriate help, and knowledge in seeking mental health information. Furthermore, the frequency of classroom interaction was positively correlated with improvements in mental health literacy (regression coefficient = 2.261***), highlighting the critical role of active participation in public art education settings. This study underscores the importance and effectiveness of implementing public art education in higher education and provides empirical support for future educational policies and practices.

Developmental Assets and Their Relationship to Suicidal Behavior in Mexican Young Adults.

Suicide in young people is a public health problem. Typically, protective factors for suicide are not studied; research tends to focus on measuring risk factors. However, knowing the risk factors does not mean that we also know the opposing factors that influence a group's health problems. For this reason, we examined the relationship between developmental assets in Mexican youth aged 18 to 25 years who are not at risk for suicide, exhibit self-injurious behavior, and whose last suicide attempt had low or high lethality. A cross-sectional study of 478 young people (73% female and 27% male) from Mexico City was conducted using an online survey and correlations were tested with dummy variables (groups) and multinomial logistic regression. The no-risk group showed associations with all developmental assets, the self-injurious group had an association with the house rules variable, the low lethality group was correlated with twelve assets and the high lethality group with four assets. Four internal developmental strengths were significant in the regression model: avoidance of risk behaviors, school expectations, resistance to pressure, and expression of anger. These results suggest that PYD is a useful framework for examining suicide risk and promotes skill development in young college students.

Social Media Effects Regarding Eating Disorders and Body Image in Young Adolescents.

The following study investigates how eating problems and young people's body image are affected by social media. As social media becomes more pervasive, young teenagers are exposed to many pictures, messages, and influencers encouraging unachievable body and beauty ideals. The study investigates the link between social media usage and the development of binge eating disorder patterns and undesirable body image judgments. It also sheds light on the influence that so-called social media influencers and celebrities have on encouraging disordered eating patterns and forming negative body image perceptions. On websites like Instagram and TikTok, exposure to deliberately selected photographs of "ideal" body types encourages body dissatisfaction and poor self-worth. The research emphasizes social media's possible harm to this vulnerable group's physical and mental health by examining pertinent literature and empirical evidence. It also looks at potential safeguards and methods for fostering good mental and physical health in early adolescents during pervasive social networking site use. Promoting fad diets, weight-loss aids, and the exaltation of extreme thinness aids in the normalization of harmful behaviours. Social media's negative consequences on eating disorders and body image in young teenagers are highlighted by this study in its conclusion. As a critical developmental stage, early adolescence is vulnerable due to the effect of social media, which could normalize unhealthy behaviours and maintain negative body image and insecurities. The findings underscore the need for targeted interventions and educational programs to mitigate the adverse effects of eating problems and young people's body image in light of social media.

Efficacy of a virtual nursing simulation-based education to provide psychological support for patients affected by infectious disease disasters: a randomized controlled trial.

Virtual simulation-based education for healthcare professionals has emerged as a strategy for dealing with infectious disease disasters, particularly when training at clinical sites is restricted due to the risk of infection and a lack of personal protective equipment. This research evaluated a virtual simulation-based education program intended to increase nurses' perceived competence in providing psychological support to patients affected by infectious disease disasters. The efficacy of the program was evaluated via a randomized controlled trial. We recruited 104 nurses for participation in the study and allocated them randomly and evenly to an experimental group and a control group. The experimental group was given a web address through which they could access the program, whereas the control group was provided with a web address that directed them to text-based education materials. Data were then collected through an online survey of competence in addressing disaster mental health, after which the data were analyzed using the Statistical Package for the Social Sciences(version 23.0). The analysis showed that the experimental group's disaster mental health competence (F = 5.149, p =.026), problem solving process (t = 3.024, p =.003), self-leadership (t = 2.063, p =.042), learning self-efficacy (t = 3.450, p =.001), and transfer motivation (t = 2.095, p =.039) significantly statistically differed from those of the control group. A virtual nursing simulation-based education program for psychological support can overcome limitations of time and space. The program would also be an effective learning resource during infectious disease outbreaks. This Korean clinical trial was retrospectively registered (21/11/2023) in the Clinical Research Information Service ( https://cris.nih.go.kr ) with trial registration number KCT0008965.

Role of Psychoeducation in Enhancing Young Adults’ Mental Health and Life Adjustment during the Covid-19 Pandemic Research

The ongoing Covid-19 pandemic has a severe impact on people's lifestyles and health all around the world, including Bangladesh. The current study sought to determine if psychoeducation can improve the mental health and life adjustment of young adults in Bangladesh during the COVID- 19 crisis. 30 undergraduate students with high GFQ scores, from two public universities in Dhaka city, were purposefully sampled for the study using a quasi-experimental pretest-posttest design with a control group. The participants were divided into two groups: the experimental group and the control group, each with 15 respondents. The findings of the present study showed the benefits of psychoeducation on the young adults’ mental health and life adjustment. The experimental group's mental health and life adjustment both significantly improved as a result of the psychoeducation intervention, which accounted for 88.8% of the variance in the former and 80.2% in the latter. However, participants who did not receive intervention showed no significant differences in either their mental health or life adjustment. The results may help mental health experts create programs to help young adults who are having problems with their mental health and adjustment. 
 Jagannath University Journal of Science, Volume 10, Number I, Jun 2023, pp. 11−18

Leaving no one behind? Addressing inequitable HIV outcomes by attending to diversity: A qualitative study exploring the needs of LGBTQI+ young people living with HIV in Zimbabwe.

Leaving nobody behind in the fight to end the HIV epidemic as a public health threat depends on addressing inequities in optimal HIV outcomes. Consistently overlooked in research, policy and programming are young lesbian, gay, bisexual, transgender, queer/questioning and intersex (LGBTQI+) people who are living with HIV. This study engaged young LGBTQI+ people in Zimbabwe to better understand their experiences of living with HIV and the support they need. Between September 2022 and February 2023, we conducted qualitative research with 14 LGBTQI+ young people (18-24 years), (two focus group discussions and in-depth interviews with 5/14). All 14 participants were accessing a LGBTQI+ HIV support group at Zvandiri ('As I Am'), a well-established community-based HIV program. We conducted thematic analysis and key findings informed the collaborative development of internal activities to further enhance inclusivity of LGBTQI+ young people within Zvandiri's programs. There was consensus among participants that being LGBTQI+ and living with HIV leads to "double stigma and double trouble", involving physical and verbal harassment, social exclusion and family rejection. Participants concealed their LGBTQI+ identity and HIV status in most situations, and many withheld their HIV status in LGBTQI+ social spaces, including community-led LGBTQI+ services. This negatively impacted their psychosocial well-being and social connectedness. Participants described positive experiences of Zvandiri. Interacting with others living with HIV in a destigmatising environment promoted self-acceptance. However, reflecting their prevailing experiences, participants were cautious about revealing their sexuality and/or gender identity at Zvandiri outside of their support group. Ensuring equitable access to HIV care, including mental health support, relies on understanding the challenges experienced by those most marginalised. Critically important is understanding the impact of intersectional stigma on LGBTQI+ young peoples' social lives, and their access to services. Community-based HIV support programs are well-positioned to support and advance this group's health rights.

EXAMINATION OF THE RELATIONSHIP BETWEEN HEALTH LITERACY AND THE LEVEL OF ADAPTATION TO DISEASE IN INDIVIDUALS WITH CHRONIC DISEASES

Aim: This study aimed to determine the health literacy levels of patients applying to the Family Health Center and investigate the relationship between their health literacy levels and their adaptation to chronic diseases. Methods: Our study was planned and implemented as a single-center, cross-sectional and survey study. 328 individuals over the age of 18 and with chronic diseases who applied to Ertuğrul Education Family Health Center No. 36 between August 2020 and January 2021 were included. A 62-question survey including socio-demographic questions, Chronic Disease Adaptation Scale and Turkish Health Literacy Scale-32 (THLS-32) was applied to the participants. Results: The study group's health literacy general index score average was found to be 33.42±8.76, and the general index score average for adaptation to chronic diseases was 80.75±12.62. According to the results of the correlation analysis, a significant and positive relationship was found between the total score of adaptation to chronic diseases and the total score of health literacy (r = .314, p < .001) and its subgroups (p < .001). A significant and positive relationship was found between the physical adaptation subscale score, the health literacy total score, and its subgroups (p < .001). According to the results of the correlation analysis, a significant and positive relationship was found between the psychological adaptation to chronic diseases subscale score and the health literacy total score and subgroups (p < .05). Conclusions: Healthcare personnel's awareness of patients’ health literacy level and their intervention is essential in ensuring that individuals comply with treatment and increasing the quality of healthcare services.

Financial Risk Management of FK Coal Group: Basis for Policy and Strategy Formulation

This study delves into the financial risk management of FK Coal Group in China, focusing on aspects such as credit risk, liquidity risk, stability risk, and profitability risk. The research aims to provide a comprehensive profile of FK Coal Group, including its organizational structure, years in operation, number of employees, geographical scope, and asset size as of 2022. The financial risks are primarily associated with debt payments, asset management, the company's capacity to meet expenses, and production costs and outputs. The financial risk management process encompasses risk identification, analysis, evaluation, and treatment. Challenges are encountered in each phase, such as uncertain adverse events, risk assessment accuracy, risk mitigation strategies, and risk reduction and avoidance measures. The survey results from the employees of FK Coal Group reveal that it is a state-owned enterprise with a long operational history, a substantial workforce, and strong assets, primarily operating in the domestic and international markets. The study underscores the critical role of financial risk management in ensuring the company's operational continuity and competitiveness. Effective risk planning and monitoring are highlighted as crucial elements to improve profitability and prevent excessive spending or losses. The proposed financial risk management policy or strategy aims to address these challenges comprehensively, focusing on proactive risk identification, thorough risk analysis, robust risk evaluation, and appropriate risk treatment strategies to minimize adverse impacts on FK Coal Group's financial health and performance.

Longitudinal Sleep Patterns and Cognitive Impairment in Older Adults

Sleep disturbances and clinical sleep disorders are associated with all-cause dementia and neurodegenerative conditions, but it remains unclear how longitudinal changes in sleep impact the incidence of cognitive impairment. To evaluate the association of longitudinal sleep patterns with age-related changes in cognitive function in healthy older adults. This cross-sectional study is a retrospective longitudinal analyses of the Seattle Longitudinal Study (SLS), which evaluated self-reported sleep duration (1993-2012) and cognitive performance (1997-2020) in older adults. Participants within the SLS were enrolled as part of a community-based cohort from the Group Health Cooperative of Puget Sound and Health Maintenance Organization of Washington between 1956 and 2020. Data analysis was performed from September 2020 to May 2023. The main outcome for this study was cognitive impairment, as defined by subthreshold performance on both the Mini-Mental State Examination and the Mattis Dementia Rating Scale. Sleep duration was defined by self-report of median nightly sleep duration over the last week and was assessed longitudinally over multiple time points. Median sleep duration, sleep phenotype (short sleep, median ≤7 hours; medium sleep, median = 7 hour; long sleep, median ≥7 hours), change in sleep duration (slope), and variability in sleep duration (SD of median sleep duration, or sleep variability) were evaluated. Of the participants enrolled in SLS, only 1104 participants who were administered both the Health Behavior Questionnaire and the neuropsychologic battery were included for analysis in this study. A total of 826 individuals (mean [SD] age, 76.3 [11.8] years; 468 women [56.7%]; 217 apolipoprotein E ε4 allele carriers [26.3%]) had complete demographic information and were included in the study. Analysis using a Cox proportional hazard regression model (concordance, 0.76) showed that status as a short sleeper (hazard ratio, 3.67; 95% CI, 1.59-8.50) and higher sleep variability (hazard ratio, 3.06; 95% CI, 1.14-5.49) were significantly associated with the incidence of cognitive impairment. In this community-based longitudinal study of the association between sleep patterns and cognitive performance, the short sleep phenotype was significantly associated with impaired cognitive performance. Furthermore, high sleep variability in longitudinal sleep duration was significantly associated with the incidence of cognitive impairment, highlighting the possibility that instability in sleep duration over long periods of time may impact cognitive decline in older adults.

The Relationship between Oral Health and Schizophrenia in Advanced Age-A Narrative Review in the Context of the Current Literature.

Schizophrenia is a psychiatric disorder that makes patients incompetent to perform day-to-day activities due to their progressing mental illness. In addition to disturbances with thoughts, behavioral changes, and impaired cognitive functions, oro-systemic health also becomes compromised. Even though the population with schizophrenia is primarily made up of older people, little is known about this group's oral health treatment. The present review explores the relationship between oral healthcare and elderly patients with schizophrenia. Our literature search included databases, like PubMed, Embase, and Google Scholar, for appropriate and evidence-based information. Preventive and management strategies outlined in the included articles and future research perspectives in this field are discussed. To the best of our knowledge, this is the first review that looked at dental care and related characteristics in older schizophrenia patients. The findings highlight the necessity for targeted dental interventions to address the dental health challenges faced by this vulnerable population. Integrating dental health into the overall medical management of elderly individuals with schizophrenia is crucial. Although specific therapies remain limited, the emphasis is on preventive dentistry to reduce the occurrence and progression of oral diseases in this group.

Factors associated with depression and suicidal ideation among oldest-old adults aged 85 years or older based on gender, using the survey data of South Korea.

South Korea is predicted to become a superaged society around 2025. Depression in older adults is a major factor influencing suicide. South Korea exhibits the highest suicide rate among the Organization for Economic Co-operation and Development countries. This study aimed to examine the factors associated with depression and suicidal ideation among individuals aged 85 years or older based on gender. Data were obtained from the Korea Institute for Health and Social Affairs, 2017. Overall, 768 individuals aged ≥85 years were included in the final analysis. The participants' general, health-related, and social characteristics were analyzed as factors influencing depression and suicidal ideation. Among male oldest-old adults, living arrangements and the number of chronic diseases were factors affecting depression, while activities of daily living restrictions and the number of chronic diseases were factors affecting suicidal ideation. Among female oldest-old adults, only the number of chronic diseases affected depression, while financial status and the number of chronic diseases were the factors affecting suicidal ideation. The healthcare and welfare services for older adults must be expanded to cater to oldest-old adults who live alone, have activities of daily living restrictions, and have lower financial status. Additionally, the oldest age group's psychological health must be monitored regularly for depression and suicidal ideation to implement active interventions for this high-risk group.

An Exploration of The Lived Experience of Informal Student Carers During Covid-19

Informal Student Carers (ISC) are students who provide unpaid care to a friend or family member needing support. We explored the lived experiences of ISC and the challenges they faced throughout the Covid-19 pandemic. A scoping review, questionnaire-based survey and volunteer interviews were undertaken to identify the themes which predicate student carer’s experience during the Covid-19 pandemic. Our research showed that a combination of financial concerns, time constraints, and the lack of visibility of student caregivers all contributed to this student group's poor mental health during the Covid-19 pandemic. Educational institutions have an obligation to be informed and support the unique and varied needs of ISCs.

Investing in the future: prioritizing adolescent health in Pakistan

Adolescence is the stage of life between ages 10 and 19, marking the journey from childhood to adulthood, and is considered the most critical time of human development. During this time, many significant physical, psychological, sexual, reproductive, and social changes occur, making it a critical phase of life. Despite the fact that approximately 21% of Pakistan's population consists of adolescents, the country currently lacks almost any policies focused on promoting adolescent health. Adolescents in Pakistan face significant challenges due to the lack of access to physical, mental, and sexual health services and limited opportunities for physical activity and recreation. Therefore, it is crucial to prioritize this population group's health and well-being to address these pressing concerns by employing a holistic approach so that young people can be empowered to make informed decisions.

The effect of a modified perioperative management model on the mental state, quality of life, and self-care ability score of patients after radical prostatectomy: A retrospective study.

To explore the effects of an improved perioperative management model on the mental state, quality of life, and self-care ability scores of patients after radical prostatectomy. Overall, 96 postoperative prostate cancer patients admitted to our hospital between November 2019 and May 2021 were retrospectively analyzed and classified into an observation group and a control group with 48 patients each, according to the management model they received. The patients in the control group received routine care and were discharged. The observation group implemented an improved perioperative management model than the control group. Differences in mental state, quality of life, and self-care ability scores between the 2 groups were compared. After nursing, the self-rating anxiety scale and self-rating depression scale scores of the 2 groups were significantly lower than those before nursing, and the observation group's self-rating anxiety scale and self-rating depression scale scores were significantly lower than those of the control group (P < .05). Regarding emotion, cognition, and society, the observation group's quality of life scores was significantly higher than those of the control group. In contrast, overall health was significantly lower than that of the control group (P < .05). After nursing, the observation group's self-care skills, self-responsibility, health knowledge, and self-concept scores were significantly better than those of the control group (P < .05). The improved prostate cancer perioperative management model helps improve patients' unhealthy mental state, quality of life, self-care ability, and provides guidelines for the clinical care of patients after prostate cancer surgery.

Remembering Ruth Milligan Ballweg, MPA, PA-C Emeritus.

Remembering Ruth Milligan Ballweg, MPA, PA-C Emeritus.

Application of a β-mannanase enzyme in diets with a reduced net energy content in post-weaning piglets resulted in equal performance and an additional economic benefit

β-Mannans are strongly anti-nutritive polysaccharide fibers found in most vegetable feed ingredients. The estimated content of soluble β-mannans in common swine diets range from 0.15 to 0.40%. In vitro studies have demonstrated that as little as 0.05% soluble β-mannan content in feed can elicit a strong innate immune response. Hemicell HT (Elanco Animal Health) is a β-mannanase enzyme for animal feed that breaks down β-mannans, thereby preventing economic losses from the wasteful immune response to β-mannans. The present study aimed to compare pig performance on a control diet and a reformulated diet with a lower energy content – 45 kcal/kg NE reduction – and the inclusion of a β-mannanase enzyme. A six-week feeding trial was conducted on a commercial post-weaning facility with DanBred x Belgian Piétrain pigs starting at 21 days of age. Standard three-phase control diets were compared to reformulated diets with an energy reduction of 45 kcal NE/kg and inclusion of a β-mannanase enzyme (Hemicell HT; Elanco) at 300 g/tonne. Standard production data were collected. The data were analyzed using JMP 15.0 statistical program. Overall, performance data did not differ significantly between trial groups in both Phase 1 and Phase 2, and overall, during the entire post-weaning period. Mortality was only numerically, but not significantly higher in the Control as compared to the Hemicell HT group. Hemicell HT had an overall benefit of € 1.69 per piglet and € 15.18 per tonne of feed due to the 45 kcal/kg NE reduction. The current trial demonstrated that the inclusion of Hemicell HT in reformulated diets with a lower energy content (45 kcal NE/kg) was able to retain production performance in post-weaned piglets with an economic benefit.

Stressful life events, psychological symptoms, and social support of children and young asylum-seekers in Iceland.

Children and young asylum-seekers are often exposed to stressful life events (SLEs) and risk developing psychological symptoms. However, risk and protective factors can positively and negatively influence this vulnerable group's mental health. To examine the SLE experiences and psychological symptoms of children and youth who seek refuge in Iceland. And to study the role that gender, travelling (un)accompanied and perceived social support play in the development of psychological symptoms for this population. Participants were 75 children and youth of ages 13 to 24 years who sought asylum in Iceland (M = 19.7, SD =3.0, 66.7% male). Sociodemographic and social support data were collected via face-to-face interviews, with the help of interpreters when required, while SLEs, post-traumatic stress, depression, anxiety and behavioural symptoms measures were administered to participants. The results indicated that participants who travelled alone to Iceland had experienced more SLEs than those who travelled accompanied. SLE experiences were associated with post-traumatic stress disorder (PTSD) and other psychological symptoms. Results also revealed that SLE and perceived peer support played a significant role in predicting PTSD symptoms. Children and young asylum-seekers are exposed to a high number of SLEs, which increases their risk of developing psychological problems. This potential risk underlines the need for early assessments and intervention. Moreover, higher levels of social support were related to less severe PTSD symptoms, suggesting that social resources act as protective factors for these children and youth in helping them cope with SLEs.